Health care utilizations and costs of Campylobacter enteritis in Germany: A claims data analysis.

OBJECTIVE: The number of reported cases of Campylobacter enteritis (CE) remains on a high level in many parts of the world. The aim of this study was to analyze the health care utilizations and direct and indirect costs of CE and sequelae of patients insured by a large health insurance with 26 million members in Germany. METHODS: Claims data of insurants with at least one CE diagnosis in 2017 (n = 13,150) were provided, of which 9,945 were included in the analysis of health care utilizations and costs. If medical services were not diagnosis-linked, CE-associated costs were estimated in comparison to up to three healthy controls per CE patient. Indirect costs were calculated by multiplying the work incapacities by the average labor costs. Total costs of CE in Germany were extrapolated by including all officially reported CE cases in 2017 using Monte Carlo simulations. RESULTS: Insurants showed a lower rate of 56 CE diagnoses per 100,000 than German surveillance data for 2017, but with a similar age, gender and regional distribution. Of those CE cases, 6.3% developed post-infectious reactive arthritis, Guillain-Barré syndrome (GBS), inflammatory bowel disease (IBD) and/or irritable bowel syndrome (IBS). Health care utilizations differed depending on CE severity, age and gender. Average CE-specific costs per patient receiving outpatient care were € 524 (95% CI 495-560) over a 12-month period, whereas costs per hospitalized CE case amounted to € 2,830 (2,769-2,905). The analyzed partial costs of sequelae ranged between € 221 (IBS) and € 22,721 (GBS) per patient per 12 months. Total costs of CE and sequelae extrapolated to Germany 2017 ranged between € 74.25 and € 95.19 million, of which 10-30% were due to sequelae. CONCLUSION: CE is associated with a substantial economic burden in Germany, also due to care-intensive long-lasting sequelae. However, uncertainties remain as to the causal relationship of IBD and IBS after CE.

Comparison of Targeted (HPLC) and Nontargeted (GC-MS and NMR) Approaches for the Detection of Undeclared Addition of Protein Hydrolysates in Turkey Breast Muscle.

The adulteration of fresh turkey meat by the undeclared addition of protein hydrolysates is of interest for fraudsters due to the increase of the economic gain by substituting meat with low cost ingredients. The aim of this study was to compare the suitability of three different analytical techniques such as GC-MS and 1H-NMR with HPLC-UV/VIS as a targeted method, for the detection of with protein hydrolysates adulterated turkey meat. For this, turkey breast muscles were treated with different plant- (e.g., wheat) and animal-based (e.g., gelatin, casein) protein hydrolysates with different hydrolyzation degrees (15-53%: partial; 100%: total), which were produced by enzymatic and acidic hydrolysis. A water- and a nontreated sample (REF) served as controls. The data analyses revealed that the hydrolysate-treated samples had significantly higher levels of amino acids (e.g., leucine, phenylalanine, lysine) compared with REF observed with all three techniques concordantly. Furthermore, the nontargeted metabolic profiling (GC-MS and NMR) showed that sugars (glucose, maltose) and/or by-products (build and released during acidic hydrolyses, e.g., levulinic acid) could be used for the differentiation between control and hydrolysates (type, degrees). The combination of amino acid profiling and additional compounds gives stronger evidence for the detection and classification of adulteration in turkey breast meat.

A novel method for in situ detection of hydrolyzable casein fragments in a cheese matrix by antibody phage display technique and CLSM.

A novel method to monitor in situ hydrolyzable casein fragments during cheese ripening by using immunofluorescent labeling and confocal laser scanning microscopy (CLSM) was developed. Monoclonal single chain variable fragments of antibody (scFvs) were generated by antibody phage display toward three small synthetic peptides of the alpha(s1)-casein sequence. These peptides traverse enzymatic cleavage sites of casein during cheese ripening. The specificity of the generated anti-peptide antibodies was determined by ELISA and Western blot. Finally, an immunofluorescent labeling protocol was successfully developed for the detection of scFvs binding to different alpha(s1)-casein fragments inside a cheese matrix by CLSM. To our knowledge, this is the first demonstrated immunofluorescent labeling method for in situ analysis of proteolysis phenomena in the cheese matrix. Additionally, this technique offers a high potential to study in situ dynamic spatial changes of target components in complex food systems.